%0 Journal Article
%T Passive Posterior Tibial Subluxation on Routine Knee MRI as a Secondary Sign of PCL Tear
%A Andrew J. Degnan
%A Catherine Maldjian
%A Richard J. Adam
%A Christopher D. Harner
%J Radiology Research and Practice
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/715439
%X The posterior drawer test is an accurate clinical test to diagnose posterior cruciate ligament (PCL), indicating laxity of the PCL that allows posterior tibial translation. This study aimed to determine whether posterior tibial translation relative to the femur on routine MRI could serve as an additional sign of PCL tear. Routine knee MRI in eleven patients (7 males, 4 females) with arthroscopically confirmed isolated PCL tears were reviewed independently by two musculoskeletal radiologists. Measurements of tibial translation were made in the medial and lateral compartments of patients and controls (10 males, 12 females) without clinical or MRI evidence of ligament injury. Significant medial compartment posterior tibial translation was present in patients with PCL tear compared to controls (+2.93£żmm versus +0.03£żmm, ) with excellent interobserver agreement (intraclass correlation coefficient (ICC) = 0.94). No significant difference in lateral compartment tibial translation was observed (+0.17£żmm versus £ż0.57£żmm, ) despite excellent interobserver agreement (ICC = 0.96). Posterior tibial translation in the midmedial compartment may be a secondary sign of isolated PCL tear on routine knee MRI with passive extension without manipulation or weight bearing. Additional work in a larger cohort may better address the accuracy of this finding. 1. Introduction Posterior cruciate ligament (PCL) tears can have deleterious long-term consequences and therefore surgical repair has become a more widely utilized treatment option. In the setting of multiligament injuries, arthroscopy for other injuries may reveal occult PCL tears. In the setting of isolated PCL tear where arthroscopy is not performed, PCL tears that are missed clinically might only be detected on MRI. However, discontinuity of the PCL is not always seen on MRI. Therefore, various indirect signs have been invoked to diagnose PCL tears. Several indirect signs of PCL tears have been suggested, including posterior cruciate ligament thickness, ligamentous laxity, and increased intrasubstance signal [1]. The posterior drawer test is the most accurate clinical test to diagnose PCL tears; however, posterior subluxation often cannot be elicited with this maneuver in the acute setting due to soft tissue swelling and pain [2]. The purpose of this study is to determine if there is significant passive posterior translocation of the tibia relative to the femur in patients with isolated PCL tears on routine MR imaging without weight-bearing or manipulation. 2. Materials and Methods 2.1. Study Participants Institutional
%U http://www.hindawi.com/journals/rrp/2014/715439/